While the behemoth trucks often drive annoyingly slow on uphill climbs, they fly scarily fast going downhill, becoming zooming boulders that can crush smaller vehicles with a moment’s inattention.

What many don’t consider, though, is how trucking as a profession can quickly become crushing to the drivers themselves.

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“I'd like people to come away with a little more compassion for the job,” says Mona Shattell, the author of several scientific surveys of the mental and physical health of long-haul truckers. “Because I know I did, after doing all this research. It is ... really hard.”

Truck driving is, without a doubt, one of the most brutal jobs a person can do. Across the board, long-haul truckers have higher rates of obesity, diabetes, anxiety, depression, cardiovascular disease, divorce, and drug use than the average American. Their on-the-job fatality rates are a ridiculous 11 times higher than average. The mental issues tend to play off the physical issues and vice versa, churning up a whirlwind of work-related trauma.

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“Two drivers actually said that they drive better when they're on crack than without, because they're more aware of their environment. How scary is that?”

In terms of physical challenges, sitting upright in a chair, even a thousand-dollar chair, for 10 hours a day is completely brutal on the human body. Truckers are highly prone to musculoskeletal issues, back problems, neck problems, knee problems. The vibration of the truck bed (a constant, low-grade rumble) is murder on the spinal system.

For all the external blows to a trucker’s body, it’s their eating habits that are an even bigger concern.

“Their diet is terrible,” Shattell says. Food at truck stops is notoriously abysmal, and truckers don’t have time to leave the highway in search of healthier food—if it even exists in their area. Exercise, too, is, for the most part, non-existent. There simply isn’t time, and, after the workday, truckers are exhausted.

Organizations like The Healthy Trucker are making strides to help teach truckers workouts that are easy to do in small spaces, including stretches to alleviate neck and back pain. The website also offers tips on where to find healthier food, and relationship advice to mitigate the difficulty of being away from family. (The national divorce rate is 3.6 percent, but among truckers it’s an insane 19.5 percent.)

The impact of these new resources, though, remains to be seen. Today, truckers continue to have the highest incidence of obesity of any occupational group, averaging around 240 pounds.

The physical isolation, by definition part of the job, can also be crippling. Truckers can communicate by phone and CB radio, and Shattell says there is a touch of self-selection at work (people more inclined to like alone time choose the career). There are few other occupations, though, that require a similar level of isolation, and for obvious reasons. Extreme isolation is not a pleasant situation for even the most introverted among us.

• Keep on Truckin': The Keep on Truckin' project is an effort to shine a light on the past, present, and future of the truck driving industry in America, exploring all facets of our most pivotal, and overlooked, economic engine.

• CB Radio: A History: An illustrated guide to the connection between CB radio culture and modern forms of short-form communication.

“Of course they're related, mental health and physical health,” Shattell says. “We found a lot of loneliness, anxiety, [illegal] substance use, and unsafe sex. Depression is a problem, and, untreated, it can get worse.” According to the Centers for Disease Control and Prevention, truck driver suicide rates are among the top five professions in the country.

Drugs, alcohol, and sex work patronage are all often used as self-treatment options, given the lack of easily found medical and mental health assistance. But the types of drugs preferred by truckers might come as a bit of a surprise. The logical choice would be amphetamines, like speed, which enhance a driver’s ability to stay awake and focused on driving.

“I thought it would be more of that, but it was a lot of cannabis—pot—and crack,” Shattell says. “Two drivers actually said that they drive better when they're on crack than without, because they're more aware of their environment. How scary is that?”

The core issues facing truck drivers haven’t changed in many decades, and there’s seemingly no real way to mitigate the risks involved without a full overhaul of the profession.

In recent years, attempts have been made to improve the quality of life for truckers through policy. New federal regulations enacted in 2013 reduced the number of hours a trucker can drive per week. A trucker on the road today can work a maximum of 70 hours, which must be followed by at least 34 hours of non-work before the next workweek can begin. Drivers are limited to 11 hours of driving per day, which must include a minimum 30-minute break within the first eight hours. Perhaps most importantly, drivers are now required to have yearly physical check-ups.

Sadly, these changes have made little impact thus far on the day-to-day lives of truckers. “People are forced to sleep when they might not be tired, and stay awake when they might be tired,” Shattell says.

The worst part about the lifestyle of the long-haul trucker, though, is how hard it is to get any help. Time is such a pressing issue that truckers are unable to stop and exercise, much less venture out to find healthier food or medical care. Shattell also notes that the truck itself makes seeking out, say, medical care incredibly difficult. Where are you going to park a giant truck if you need to see a doctor?

Given how much the trucking industry impacts the rest of the country, from highway safety to health-care affordability, the problems faced by truckers should be of the utmost importance. Sure, there’s a distinct loner, libertarian, anti-regulation bent within the trucking industry, but the health of drivers—both mental and physical—is crucial for the American economy.

Shattell and other advocates have helped identify the problem, but tangible solutions still escape the industry. “There are a lot of long-haul truckers [with] a lot of unmet needs,” she says.

The Keep on Truckin' project is an effort to shine a light on the past, present, and future of the truck-driving industry in America, exploring all facets of our most pivotal, and overlooked, economic engine.